The care we expect in old age will depend on how much we want to pay

By Pat Sparrow

Recent media coverage has cast aged care in a negative light, based on individual experiences of care. These instances warrant our close attention as providers, residents and families – and as taxpayers who ultimately fund 80 per cent of the costs.

Aged care is a human service and is not perfect. As providers, we are as concerned as anyone about providing the best service we can and fixing problems where they occur. Those of us who work within the industry on a daily basis strive to provide quality care and genuinely care about what we are doing.

One of the problems we often see is a mismatch between what the community expects us to deliver, and what we are funded to deliver.

The aged-care industry supports over 1.3 million older Australians. Between now and 2050, the proportion of people aged over 65 in Australia is expected to double, from 13 per cent to about 27 per cent.

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The government, that is taxpayers, will need to significantly increase its outlay on aged care in coming decades to meet the upcoming demographic challenge.

The government, that is taxpayers, will need to significantly increase its outlay on aged care in coming decades to meet this demographic challenge head-on.

The hard question in that discussion will be: what can and should be funded by the taxpayer and what should be funded by the individual? For example, in determining how much government funds and how much the individual pays, how do we take account of the largest asset most Australians own – their home?

While some of these questions and conversations will be politically uncomfortable, it is the only way we can determine the sort of aged care society expects to be provided, and how we can afford that care into the future.

Recent commentary has focused on the fact that providers are making surpluses. Surpluses are necessary to ensure services are sustainable, and in the not-for-profit sector are reinvested back into service delivery and infrastructure.

When making the difficult choice to enter residential care, it is imperative to be able to trust in the quality of care on offer.

And contrary to that commentary, not all providers are making large surpluses. Many are doing it tough. Providers in rural and remote communities are struggling to remain viable, and those communities are at risk of losing access to essential aged care services.

We need to address the financial sustainability of the system, but we also need to shift our service delivery to what it is that older Australians want and the way that they want to receive aged care.

An increasing proportion of older Australians have a preference to remain at home as they age, but for many – when that option is no longer a possibility – residential aged care is the environment that will meet their needs. When an individual or a family makes that difficult choice, is it imperative they have trust in the quality of care their family member will receive.

We don't believe that the system is broken, as some commentators do. But ongoing reform is needed. Aged care reforms over a number of years, introduced by governments of both persuasions, have been focused on increasing the choice and control older Australians and their families have. This is an important directional shift, and one that needs to continue.

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If the recent media attention achieves anything, I hope it can be to start a constructive community dialogue about what is expected of aged care service providers, and how it can be funded in a sustainable way into the future using both public and private funding.